Raynaud's Phenomenon of the Nipples

Just when you thought you had heard of everything: did you know that Raynaud's phenomenon can affect the nipples almost as often as it affects the fingers? Raynaud's phenomenon is an intermittently decreased blood flow to certain areas of the body (most commonly fingers or toes), that may affect the nipples as well, particularly in nursing women. Nipple pain is one of the most common reasons that women prematurely discontinuing breastfeeding; Raynaud's phenomenon is one of the most common causes of nipple pain, but also one of the most commonly overlooked. Raynaud's phenomenon is a condition that mostly affects women: it is nine times more prevalent in women than men. Estimates are that up to 20% of healthy women ages 21-50 may be affected. However, most women--and many physicians--are not aware that Raynaud's may affect the nipples. The good news is that this is generally treatable. Ironically, because the breast pain associated with Raynaud's phenomenonis so severe and throbbing, and the awareness of this condition is relatively low, it is often inappropriately mistaken for a yeast infection of the nipples. Symptoms may also occur during pregnancy.

Treatment options include preventing or minimizing cold exposure, avoiding substances such as vasoconstrictive drugs or nicotine, and medical therapy. Nifedipine, a calcium channel blocker (available by prescription only), has been used to treat Raynaud's phenomenon because of its prompt vasodilatory effects.Very little of the medication can be demonstrated in breastmilk and thus it is believed to be safe for breastfed babies. Some lactation specialists recommend Vitamin B6 therapy (150-200 mg/day once a day for four days, followed by 25 mg/day once a day) which has shown to work in some cases after a few days, although there is no scientific evidence to support it.

Created: 12/13/2004  -  Donnica Moore, M.D.